The nurse is caring for a male patient with sepsis. He weighs 90 kg and his urine output has been 175 mL over 6 hours. The nurse suspects acute kidney injury when the creatinine is

1.9 mg/dL.

Explanation

• Acute kidney injury (AKI) describes the abrupt loss of kidney function resulting in the retention of urea and other nitrogenous waste products and causing dysregulation of extracellular volume and electrolytes.

• It is diagnosed by an increase in serum creatinine of 0.3 mg/dL or >50% over normal and a urine output of <0.5 mL/kg/hour for >6 hours. 

• Correct: Creatinine 1.9 mg/dL is indicative of renal failure.

• Normal range for creatinine: 0.6–1.2 mg/dL (male) or  0.5–1.1 mg/dL (female).

• In general, BUN and creatinine increase together, but because BUN often increases for other reasons, it is used as a supporting indicator of AKI, rather than as a diagnostic sign.

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